Naturally, I dissent

I had both my babies by what you might call natural childbirth.  I don't in fact call it that, partly because the term makes it sound as though the naturalness was somehow the goal in and of itself in some sort of Luddite repudiation of technology, and partly because it's yet another example of how overused and meaningless the word 'natural' is.  After all, porcelain tubs filled with hot water are no more likely to grow in the natural setting than epidurals are, but I certainly found a soak in the bath of vital importance to handling the pain in my first labour.  However, I had unassisted low-tech vaginal deliveries for both, pretty much unmedicated (I had two Paracetamol when in labour with Jamie, and a very brief go on the gas and air with Katie, but no Pethidine or epidurals).

This is, apparently, highly objectionable to Dr Crippen.  Part of this, it appears, is because he has much the same semantic objections as I do to the term itself.  Much of it, however, seems to be because he thinks, incorrectly, that natural birth is another term for homebirth.  Dr Crippen is against homebirth, which he believes to be unacceptably dangerous.  The only evidence I've seen him offer to back up this viewpoint is of the Scary Isolated Anecdote variety so beloved by, say, anti-vaccine scaremongerers, but I only read a relatively small proportion of his posts and for all I know I may at some point have missed a more rational discussion of the relative risks of homebirth and hospital birth involving the citing of some actual evidence.  However, it's a moot point, since he's wrong in thinking that natural childbirth automatically means homebirth.  It's a term generally used to refer to birth without intervention or medication, which (theoretically at least) is perfectly possible to do even in the most high-tech of hospitals.

Would Dr Crippen object to a woman having natural childbirth in a hospital?  I doubt it, but it's hard to be sure - some of his criticisms don't seem to have anything to do with the place of birth:

"Right on, trendy “natural” child birth is about jumping into the birthing pool with husb... sorry, “life partner” [Goodness.  And here was me thinking that the days when doctors could make snide comments about pregnant women not being married went out circa 1960], the vicar and the independent madwife, singing ten green bottles whilst the baby struggles to get out and then eating the placenta with a rocket salad."

All of which, of course, a woman could do perfectly well in hospital.  So what's the problem?  Well, his objection to those various potential methods by which a woman might make herself feel comfortable during labour or circumvent the lack of decent hospital food after it's over (placenta-eating isn't an idea I fancy in the slightest, but, thinking back to the quality of the only available meal on the ward the evening I'd given birth to Katie and was starving for some protein after a day of eating nothing but easily-digestible carbohydrates, I can see how it might have its attractions) is apparently that the perinatal and maternal mortality rates are unacceptable.  He does not provide any statistics or details on the impact that any of the things he listed have on intrapartum mortality, but I await with interest his presentation of the randomised controlled trials studying the mortality rates of "Ten Green Bottles" renditions.

I did not, as it happens, have any of the above in either of my births, although the lack of the birthing pool in the second certainly wasn't by my choice.  (In my first labour I used the bath instead, which worked perfectly well; whether or not that would call forth similar levels of derision from Dr Crippen, I don't know.)  For me, natural childbirth - or whatever term you can come up with that describes the choices I made concerning my children's births - wasn't about what I wanted to do during the birth, but what I wanted to avoid. 

I did not want, for example, to have major abdominal surgery on the day when a new helpless person requiring a lot of care and a lot of heavy lifting joined my family.  I did not want cuts made in my genitals.  I did not want my children's first experience of life to be the application to their heads of a suction machine vigorous enough to cause major bruising. If, of course, I found myself in a situation where the consequences of not having one of those interventions were likely to be worse than the consequences of having them, then so be it.  However, I wanted to reduce the chances as much as I could.  From my reading, there seemed to be good reason to think that the stronger forms of analgesia might increase my risk of getting one or other of those interventions, as well as having various other potential and unpleasant side effects.  So I found out as much as I could about alternative ways of dealing with labour pains, and decided to see whether I could get by on those ways if possible.  Which, as it turned out, I could.

You can't get side-effects from a drug you haven't taken or complications from an operation you haven't had.  That's why I wanted to keep intervention to a minimum.  I'd have had any intervention for which there was a genuinely good reason; but I was also aware of how often "This is just the way we do things" is considered a good enough reason on hospital wards, and I didn't consider it a good reason.  So, call it natural childbirth if you like - it's what the term means, after all - or call it by a better name if you have one.  But those were the choices I made about my labours; and those are the reasons why I made them.

Comments

[lauredhel]

Uh. That blogger claims to be a doctor, and he has never heard of the balloon/Foley method of cervical ripening/induction?

Did he get his degree from a Weeties packet?

I'm really glad for you that you had safe, normal births :)

[Mother of the Bride]

Ten green bottles - do women still mutter this? Being told by my daughter (whose baby is about the same age as KK) that practically everything I did when I had her is now out of date, I'm amazed to find that (according to Dr Crippen) ten green bottles survives. Or maybe the good doc is as old as I am? Anyway, the bottles certainly worked for me.

[Constance]

Good grief! What kind of poisoness nonsense do you expect from someone who choses the nom de plume "Dr. Crippen" who violently murdered women and was an emotionless socio/psychopath.

[Fromthestart]

*applauds*

I've had to stop reading that blog - it just made me too angry.
I completely agree with you - I wanted as intervention free as possible, and while I did use TENS and gas and air, I feel that I got exactly what I wanted in terms of a birth plan.

I definitely did NOT want an epidural that might increase my risk of forceps/ventouse/c-section, and I didn't want any drugs incase they made me vomit all over the place...

What Dr Crippen has against that kind of approach - well, I have no idea. Obviously if there was any danger to me or the baby whilst in labour, then further intervention would have been considered and taken, but there was no need.

[Sarah V.]

Lauredhel: In fairness to him, I'd never heard of that gadget either. We're GPs, not obstetricians. Then again, although I didn't get my degree from a Weeties packet, apparently the medical school I did get it from has just been found to be the worst in the country on postgraduate exam results...

Mother of the Bride: I haven't heard of anyone singing it in labour. Perhaps Dr Crippen's just showing his age?

Mom: I've been reading his blog for a year or so now, and I think he's actually an excellent doctor. He just has this tendency to inflexible views on some points, that sometimes seems to owe more to prejudice than to information.

FromTheStart: I actually don't think he is against natural birth, just homebirth. But he has this stereotype of homebirthers in his mind, and he seems to make fun of that rather than putting forward reasoned arguments.

[Fromthestart]

Sarah V - he has an abject hatred of homebirths, he sees them as massively unsafe. He calls midwives 'madwives'. He doesn't make fun of anyhing, just puts forward his very strong views on the subject, which are obviously totally correct, and god forbid that a pregnant woman wants to make her own choices about her own birth without 7 years medical training... and god help her if the midwives try and advise her in any way.

Sorry, but I have been reading his blog for a long time, and he is very black and white about these things.

[Midwifemuse]

I read Dr Crippen, sometimes I even agree with him, but his attitude toward childbirth appears to be so entrenched in medicalisation that he has me shouting at my computer screen.
It was so refreshing to read this entry, for which I have to thank Dr C, and you have put the case for attempting to encourage normality in childbirth so beautifully that I shall refer to your words when facilitating parentcraft/antenatal classes.
Thank you

[Dr John Crippen]

Hi guys

Can I go through one of the comments above? There are two sides to this story and part of the problem is that the lunatic fringe of homebirthers just put their fingers in their ears and scream "I'm not going to listen, I'm not going to listen."

*applauds*

I've had to stop reading that blog - it just made me too angry.

[There we go. So, you are not going to listen.]

I completely agree with you - I wanted as intervention free as possible, and while I did use TENS and gas and air, I feel that I got exactly what I wanted in terms of a birth plan.

[I agree with minimum intervention to, commensurate with the safety of the baby and the mother]

I definitely did NOT want an epidural that might increase my risk of forceps/ventouse/c-section, and I didn't want any drugs in case they made me vomit all over the place...

[Then don't have them. They are not compulsory. Pethidine, in particular, is a complete no no. They stopped using it years ago in the USA. I cannot believe that it is still rammed into women's thighs without so much as a by your leave in this country]

What Dr Crippen has against that kind of approach - well, I have no idea.

[I have nothing against a minimal interventional approach at all - provided it is in a place of safety]

Obviously if there was any danger to me or the baby whilst in labour, then further intervention would have been considered and taken, but there was no need.

[This is where we part company. There are some obstetric complications, such as for example prolapsed cords and post partum haemorrhage that are unpredictable and, when they happen, need immediate intervention. That is not possible at home.]

There was a midwife who lost her baby at a home birth who reported her story in the Daily Telegraqph. Quite extraordinarily, she said she was still in favour of home births. Read the story here:

http://nhsblogdoc.blogspot.com/2006/05/home-birth-tragedy.html

Absolute lunacy. Who speaks up for the interests of the baby.

I have complete respect for people who consider all aspects of an argument and discuss it rationally. I hope you will do that. But, from the tone of your comment above, I feel your fingers are already going back in your ears.

A shame

John

[Patriciaxm]

favorited this one, bro